WEIRD women have hijacked childbirth and breastfeeding

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Childbirth and breastfeeding have been hijacked by WEIRD women.

No, I don’t mean that natural childbirth advocates and lactivists are weird, they’re WEIRD: Western, educated, and from industrialized, rich, and democratic countries. It’s a term from psychology highlighting the fact that the bulk of psychology research is done on Western, educated people from industrialized, rich, and democratic countries and therefore, should not be extrapolated to everyone else.

WEIRD women view themselves as setting the standards for childbirth and breastfeeding to which other women should aspire.

There’s nothing wrong with being WEIRD; I’m WEIRD myself. There is something wrong with imagining that being WEIRD makes you a role model for others or entitles you to speak for everyone else. Sadly, that’s just what has happened in the realm of childbirth and breastfeeding:

WEIRD women believe unmedicated vaginal birth and breastfeeding are best. They insist that the scientific evidence supports their beliefs, but in fact those beliefs are often logical fallacies or based on scientific research that is riddled with confounders. For example, claiming that unmedicated vaginal birth is safest is like claiming that those who don’t take blood pressure medications are healthiest. The correlation is real, but they’ve confused cause on effect.

Sure, those who don’t need blood pressure medications are often healthier than those who do, but banning blood pressure medications will not make people with high blood pressure any healthier; indeed it will make them sicker. And waiting until someone is in the midst of a heart attack or stroke to treat their high blood pressure will not decrease heart attacks of strokes; it will just increase serious injuries and deaths.

Sure, women who don’t need interventions in childbirth often wind up with fewer complications than women who do need them, but banning interventions in childbirth will not make people who need them any healthier; indeed it will make them sicker. Waiting until someone is in the midst of an obstetric crisis to use interventions will not improve outcomes; it will just increase serious injuries and deaths. That’s exactly what happened as a result of the UK Campaign for Normal Birth; it was inevitable.

Sure, women who can breastfeed exclusively often have children who are healthier, but that’s because women who can breastfeed exclusively have adequate supply, someone to support them while they step outside the workforce to breastfeed (or a job that allows them to pump), and are typically WEIRD, having more money, greater education and better access to healthcare. Demonizing formula use, as embodied by the Baby Friendly Hospital Initiative doesn’t make babies healthier; it makes many of them sicker. And waiting until a baby is hypoglycemic, dehydrated and or jaundiced to supplement with formula does not improve outcomes; it increases injuries and deaths.

WEIRD women insist that anyone who might want to use technology in childbirth (epidurals, fetal monitoring, C-sections) or infant feeding (formula) is either uneducated or brain washed. They imagine themselves as the ideal to which other women should strive. Therefore, any woman who is not striving toward that ideal hasn’t been properly instructed or is being duped by culture of industry.

There is a great deal of academic work in midwifery that attempts to place blame for the fact that most women don’t want unmedicated vaginal birth without interventions. Grantly Dick-Read, the father of natural childbirth, insisted that it is culture that causes women to believe that they want pain relief in childbirth. Contemporary midwives and natural childbirth advocates blame medicine for promoting technology, the media for (accurately) presenting childbirth as both painful and dangerous, and male physicians who wish to commit “obstetric violence.”

There is a great deal of academic work in lactivism that attempts to place blame for the fact that many women can’t or don’t wish to breastfeed. The villain of choice in these scenarios is the formula industry, an industry that engaged in villainous conduct in the developing world in the 1970s. But the unethical conduct of formula companies in the past had nothing to do with the safety of formula. Promoting formula in the developing world can lead to infant illness and death because the water used to make it was often contaminated. Formula companies behaved in an immoral fashion, but there is nothing immoral about formula.

WEIRD women practice medical colonialism by claiming to emulate indigenous women and by lobbying international health organizations like the WHO and UNICEF to promote WEIRD beliefs in developing countries. Sadly, WEIRD women are often motivated by a sense of class and race superiority. On the one hand, natural childbirth advocates and lactivists have created with an exoticized view the poor indigenous Other (generally black or brown) and claim to be emulating them. On the other hand, they are pleased to distinguish themselves from the poor industrialized Other within their own countries (both black and white) whom they conceptualize as ignorant and lazy.

Medical colonialism isn’t merely morally repugnant, it actually kills babies. Consider the plea from Doctors Without Borders begging for formula for infants in Mosul as reported by CNN, Don’t make babies rely on breastfeeding in war zones:

The mothers who need [formula] are those facing down life-and-death situations each day, often while caring for multiple children in the shadow of war. That giving infant formula to them is so controversial speaks to a policy tripwire few outside the humanitarian realm even know exists: global “breastfeeding first” policies.

Promoting breastfeeding is a laudable goal, but in some cases, international policy ends up determining women’s on-the-ground reality, even in wartime settings, rather than the other way around. In the process, policies run the risk of treating nursing mothers as children themselves, whose needs are best known by global policy makers sitting thousands of miles away, not doctors and humanitarians nearby doing their best to help.

WEIRD women practice medical paternalism, imagining that unmedicated vaginal birth and exclusive breastfeeding must be promoted as standards to which all women should be forced to achieve. Contemporary midwifery and lactivism are all too often based on the notion that midwives and lactivists know better than women themselves. In a bitter irony, midwifery and lactivism have exchanged the patriarchy for the matriarchy.

That doesn’t mean that contemporary female arbiters don’t believe completely in their view of childbirth; they do. But believing in the value of paternalism does not justify paternalism.

In countries like the UK where midwives are gate keepers of maternity care, it is the midwife who determines whether a patient needs pain relief and whether she gets it, not the patient. It is the midwife who determines whether a woman’s performance in labor is successful, not the patient. They have perfected delaying tactics (“You don’t really need it.””You’re doing great.” “You’re almost there.”), shaming tactics, and don’t hesitate to resort to simple obstruction by refusing to call for an anesthesiologist when the patient requests it.

Such paternalism isn’t merely unacceptable, it can be deadly as the UK experience with the Campaign for Normal Birth has shown. Scores of babies and mothers have died because midwives, in their belief that they knew best, refused to employ interventions to prevent or treat complications and refused to consult with the medical specialists who could have saved lives.

WEIRD women have moralized their ideology so that they can label those who have C-sections or formula feed by choice as selfish, lazy, ignorant and duped by culture or corporations.

This type of thinking has reached its apogee in lactivist memes such as this one:

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If you don’t breastfeed you’re a selfish cunt.

Although the meme is crude, the sentiment at it’s heart is all too common. WEIRD women want to believe they are superior mothers. They wish to believe they are models that other women should emulate. And they need to believe that they set the standard to which other women not merely should aspire, but should be forced to aspire.

But WEIRD women aren’t a standard, not even for other WEIRD women; they’re just a particular cultural group whose views are not superior than the views of those who believe differently.

There’s nothing wrong with being WEIRD, of course, but there’s something very wrong with the conviction that being WEIRD means your views should be promoted by medical systems, governments and international health organizations. WEIRD women have hijacked childbirth and breastfeeding and we need to take it back from them.

  • attitude devant

    PSA: While your fertility is not fabulous in your mid-forties, you can still get pregnant until you have gone a full year without a period. (see below) Contracept, unless you truly want to be pregnant. Last year we had a 49 y/o show up 20 weeks pregnant. She thought she had the flu. Periods had been irregular for years and she hadn’t been using birth control all that time. God bless her, she was thrilled, but I personally would have been horrified. You may feel you’re too old to have a baby, but until you are completely menopausal you are not too old to get pregnant.

    • Empress of the Iguana People

      *cough, cough* Mom *cough*

  • Anion

    Can I go OT here a bit and ask for some advice (NOT medical advice per se, I swear)?

    I turned 44 in the last few weeks, I have two kids (a teen and a preteen), and I’ve just missed my second period–I’m pretty sure that what I thought was a fairly typical skipped period due to age is actually pregnancy. I’ve been drinking–not usually more than a single glass of wine or a single beer with or after dinner, but almost every evening. I smoke–not heavily, but anywhere from 5-10/day. I’m worried about what damage I might have already done. This is totally unexpected–I honestly didn’t think I *could* get pregnant anymore, so though we’ve still been using BC, we haven’t been vigilant. I’ve had two c-sections and an abdominal surgery six years ago that left me with a scar right down my stomach vertically, so I’m worried about that, too.

    AND, we’ve just moved here and our insurance hasn’t kicked in yet and I have to find an OB asap! This is where I could use some advice (although any thoughts or reassurances on the other stuff is appreciated, I don’t expect it). HOW do I find an OB in a new area where I don’t know anyone (my old OB was a friend’s recommendation, and I’d been seeing him for years as my GYN when I got married and then had both babies)? How do I approach that first visit? We want prenatal testing as soon as possible to rule out the genetic issues we know are a distinct possibility at my age; how do I ask for those? Do I do that at a first visit, or mention it when I call to set up an appt., or what? (We’ve been living abroad so really didn’t deal with this there–I just went to to the local doc for my paps, because that’s how it’s done there.) How do I do this without insurance for two more weeks–I’m reluctant to wait any longer, but I don’t want to spend thousands on stuff that *could* wait and be covered by insurance. Do I explain that to the doctor, and see what their advice is on that first visit?

    I’m very worried about how the clock is ticking. Any advice would be appreciated.

    Again, I don’t expect any real *medical* advice; I know no one could comfortably give it, and that’s fine. But tips on finding a doc, approaching that first visit, etc. would be greatly appreciated.

    Thanks in advance to anyone with anything to offer.

    • CSN0116

      How far along do you suppose you are?

      As for finding one, I would suggest a few ways:

      1. A local mommy group/facebook group. They’re overall evil, but you might use the search feature to find past conversations on the topic or make a vague, new post.

      2. If you’re close to your old GYN, call him/her and ask for a name in your new town. They may not know anyone personally, but can scan a professional registry to give who they’d suggest.

      3. Read online reviews. Look for huge, red flags that multiple posters comment on.

      4. The white pages lol. I found my beloved ob after being risked out of my midwife for a modi twins pregnancy. I called up the office closest to my house and asked to see the oldest male they had on staff (old for the experience and male because overall I find male obs more compassionate and less “well, when I gave birth to my son…”).

      You as asap for the testing, straight up, first visit. Stay away from Catholic-run health care (it’s big in my area), as you could face resistance regarding tough choices.

      GL friend!

      • Anion

        Well, I’m guessing about ten weeks, since this is missed period #2. Because we’ve just been through a major move, I’ve missed/ignored/dismissed the symptoms I’ve had, sigh–My middle’s gotten a little larger (I still fit in my jeans, but they’re a little tighter) which I thought was because I’m not doing as much walking as I did; I’ve had a few bouts of nausea (nothing huge) that I thought were just because I tend to have a nervous tummy; my tender boobs were because of new bras, you know, that kind of thing.

        Thank you for the suggestions!! I hadn’t thought of a local Mommy/FB group, that’s a great suggestion.

        And yeah…I honestly hate, hate the idea of making that tough choice, but I also know that at 44 our decision would be different than it would have been ten years ago when nothing would induce us to make that choice–we’re looking at being in our 60s with a teenager now, so that’s a big fear. I have been a bit worried about finding a doc who wouldn’t support that. Methodist health care seems to be big here, so I’ll follow my instinct to shy away from docs thus affiliated.

        Thanks again for the reply–I really, really appreciate it so much. And thanks for the goodluck wishes; I can definitely use them!!

        • Roadstergal

          My mom had me (the youngest) when she was in her 40s. It’s different for sure, but it has its own advantages. My sisters (12 and 4 when I was born) and brother (8 when I was born) were old enough to be substantively involved in raising me! And, well, there’s a certain age-related DGAF that can be refreshing in a mom… (I’m in my 40s now and finally DGAF.)

          • Anion

            Yes, that’s one thing that we’re feeling really positive about: our girls are old enough that they could really help, and that will make it so much easier. And yes, the age-related DGAF is strong in me, lol.

            Thanks so much for the response! I really appreciate it.

    • swbarnes2

      IANAD, but…

      Modest drinking like that almost certainly won’t do anything. Smoking probably won’t have done much either, but I’m less sure about that.

      The genetic testing you can get is non-invasive genetic testing, but be aware it can’t catch everything, just the blatantly obvious things, like extra chromosomes. You can do that probably at about 10 weeks, there needs to be enough fetal genetic material in your blood to be detectable. I bet the technology has advanced a lot in the last few years, I’d be looking for one that has a built in way of making sure that it is assessing the proportion of fetal DNA properly. What you do not want is a test that says “100% euploidic female, so fetus must be euploidic female” when in reality, the fetal contribution is too small to measure, and they are just measuring you.

      • Anion

        Thank you so, so much! I really appreciate it; what I’ve read has been reassuring (re the drinking etc.) but I’m still a little nervous. And thank you for the tips on the testing! Last time I was pg non-invasive genetic testing wasn’t available, so I know very little about it. I will definitely ask about that. (And yeah, I know it won’t catch everything, but at least it’s something.)

    • Young CC Prof

      Honestly, I’d pick the hospital first, and then choose an OB from the ones who practice there.

      • CSN0116

        This is a good point.

      • Anion

        Thanks! That’s an excellent idea–I’ve been sort of looking into the local hospitals, but it didn’t occur to me to think of it that way, if that makes any sense. Much appreciated!

    • MaineJen

      I’m fairly sure you don’t have to worry too much about the beer/wine. I’d hazard a guess that many/most women did at least a little drinking before they got that positive test, especially if it’s unexpected. 🙂

      And given your age, your OB will probably offer genetic testing. The quad screen and CF carrier screening are pretty standard, I don’t know about any others.

      • Anion

        Thank you! I’m trying to think positive. This is just a situation I never, ever expected to find myself in, so I’m in a bit of a tizzy! I really appreciate the response.

    • Allie

      Where do you live? I’m in B.C., Canada, and at 42 when I was pregnant, I was offered any test I wanted, right out of the gate. They offered for me to skip the screens and go straight to amnio, but we declined as we felt the amnio was too risky for us. Don’t worry about the other stuff. Your little nibblet will be just fine : )

      • Anion

        We’re in the southern US. I guess we’ll find out if it’s standard here to offer testing, too–it seems to be, from what others have said, but it’s helpful to know that it’s standard where you are. Thank you for the reply/sharing your experience, and the reassurance! It’s much appreciated.

        • attitude devant

          Be careful. Depending on where you are, the doctors may not fully disclose negative findings on testing. I met a lady on FB whose child was diagnosed with a lethal cardiac anomaly at 19 weeks in the South—–she was not offered termination.

          • Anion

            Eek. Thank you for that (sincerely)–I’ll be extra careful about whom we choose.

          • swbarnes2

            In that vein, I’d strongly consider avoiding a Catholic hospital, if you can. If something goes horribly wrong with your pregnancy, I would not count on a Catholic hospital to be honest with you about what that means, or how best to proceed to protect your own health.

          • attitude devant

            AMEN to that! I’ve been following the ACLU articles on women denied care at Catholic hospitals (an 18 weeker with ruptured membranes, a lady hemorrhaging with a miscarriage in process denied a D&C because the ultrasonographer could see a slow heartbeat) and it absolutely curls my hair.

          • Montserrat Blanco

            It sounds SO alien to me! I live in Spain, a pretty much catholic country and that would never cross our minds here. My OB professor at University was an active catholic and he defended testing and disclosing results to the parents. In the same vein he taught us that if a woman was in active miscarriage a D&C was necessary. I do not get how in a secular country like the USA it is possible for a hospital to decide which treatment should a patient get based on the hospital’s owners beliefs.

          • attitude devant

            Yeah, I don’t get it either. Particularly since Catholic health systems are heavily supported by federal monies.

          • swbarnes2

            Not just the US; remember, Savita Halappanavar was is Ireland when she died of sepsis shortly after miscarrying.

    • First things first: determine if you are actually pregnant. You can be pre-menopausal, have irregular periods for quite a long time before they cease entirely, and, although 44is a bit on the young side, not all that uncommon (my last period was when I was 46).

      Assuming you are pregnant, that amount of alcohol intake should not worry you. At your age, there should not be any problem about genetic testing — although you may have to pay for it. Since I don’t know where you are or the details of your insurance, I can’t advise.

      As to finding a doctor, do you have a family doctor who might recommend an OB/GYN colleague? Family and/or friends in the area whom you can canvass for opinions? Work associates of you or your husband? A nearby hospital, especially a teaching hospital (which might possibly run an outpatient clinic as well, which might lessen costs if you have no insurance) might be able to recommend doctors, too.

      • Anion

        Thanks so much! Yep, I need to get a test–I just wanted to have at least some idea of next steps first so I don’t totally panic when staring at a positive result. I know it’s possible I’m not, but I think the symptoms make it more likely that I am–we’ll see, though.

        We don’t have any doctor at all, no–we’ve only been in the area for a couple of months, and had all our check-ups etc. before we left our old place/country to give us some time here, and we don’t really know anyone we can ask. I will check out the hospital, though, and see what they have to say/who has privileges there from our insurance, which should be kicking in in the next couple of weeks.

        I really appreciate the advice, thanks again!

    • Empress of the Iguana People

      Sounds like your symptoms are big flags. Nothing to add on the doctor front, though I like the idea of choising one of the docs at the hospital you want to go to. That’s more or less how I did mine. These were the docs for our insurance, I went with the first one who had a convenient opening. (Clevelanders have a wealth of medical options if you’ve the insurance).
      As for your age, well, it’s a bit of a shock, of course, but if you want to have it, you won’t be alone. My youngest aunt and my mother both had babies after 40. i’ll be 58 or so when my daughter graduates high school.

      • Anion

        Thank you! Yes, the more I think back/piece things together, the more likely it seems/more certain I am, but I am going to take an actual test asap–I just wanted some advice in advance to help keep me from panicking when/if I get a positive. Shock is right, heh–we’ve been planning for the girls going off to college etc. in the next few years, so this is not what we were anticipating at all! My husband is bringing home the insurance info/providers list today or tomorrow, so I’ll start with the hospital websites and go from there.

        I really appreciate the reply, and it’s great to hear I won’t be the only one (potentially) with a high school kid at that age.

    • MI Dawn

      As to your worries about the drinks and smoking…statistically, you haven’t probably done any damage. Fetal alcohol is generally caused by heavy drinking, in the later stages of pregnancy when the brain development is maximal. Smoking is the same – a bigger deal later on, when it affects fetal growth.

      Reach out, if you can, to a local medical center (non Catholic, as noted below). They will often give you names of providers who will do the testing.

      • Anion

        Thanks so much! I really appreciate the advice and the reassurance. This is going to be a very busy few days!

    • Montserrat Blanco

      In Spain at least where I live at the moment you do not get your first prenatal appointment until 12 weeks of pregnancy, so if you are around that , I would not worry too much about getting an OB appointment.

      But first of all, get a pregnancy test. It is cheap and you will find out for sure.

      I do not know if you are living in a country where folate supplement of flour is compulsory but if that is not the case and you are pregnant, you should start taking folate supplements asap.

      It is highly unlikely that smoking and drinking those amounts has any effect on your baby.

      About choosing an OB, I would also choose the hospital first. The NICU quality and type would be my main concern, in case things go south you would like to have the best possible care, it is how I chose my hospital, but that is a personal choice of course.

      Best wishes.

      • Anion

        Thank you so much! Yes, getting a test (and some vitamins) is high on my list–we’ve had a nightmare few days trying to get everything ready for back-to-school (kids’ records from overseas didn’t translate easily so there was a lot of extra work, and they needed some shots that weren’t given where we lived before).

        And I completely agree re NICU quality and type! Going to try to find a place that isn’t rigid on the “baby friendly” regs, too, if possible, because ugh.

        I really appreciate the reassurance and the reply, thank you!

    • Daleth

      I’ve just missed my second period–I’m pretty sure that what I thought was a fairly typical skipped period due to age is actually pregnancy.

      Why haven’t you just gone to the local drug store and bought a pregnancy test? It seems like you’re getting ahead of yourself a bit here.

      • Anion

        I’m sorry, this has all just hit me at once and I haven’t gone to the pharmacy yet–it’s on my list of things to do this afternoon, it’s been an extremely busy/exhausting few days with the kids back to school and a bunch of other stuff going on. I just figured I’d get some advice in advance, so if it is positive (which I am pretty certain it will be) I’ll have a plan in place. I didn’t think there was any harm in just checking, especially since if it’s not positive I should probably see a doctor anyway given the symptoms.

  • Heidi

    On the one hand, lactivists claim women aren’t breastfeeding enough because they aren’t supported enough and support means maternity leave, lactation consultants & pumps covered by health insurance, the space and right to pump at work, joining/attending groups of breastfeeding mothers, lactation cookies, lactation supplements, paying Nikki Lee to twist you or your baby, etc. Well, my point is it seems some of them are claiming breastfeeding won’t work for Western women if things aren’t just so their boobs might not work and might not make milk. But women who are faced with malnourishment, extreme stress (and I’m gonna say living in Mosul has to be beyond terrifying), who can’t pump, bake cookies with dumb ingredients, and you know, just all the other incomprehensible crap one would have to experience in an ISIL-occupied territory, they will be able to breastfeed so long as we withhold formula?

    *Not a lactivist but I should say I support maternity leave, a space to pump in the workplace, ACA-covered pumps, and even lactation counseling for some issues.

    • Young CC Prof

      I’m betting that the answer is naturalist and vaguely racist, some kind of reference to being closer to nature and not contaminated by exposure to birth interventions and horrible formula advertisements.

  • Mel

    I’m betting that most women the world over prefer being able to provide enough nutritionally balanced food for their children as a matter of course.

    Forcing a mom in a war-zone or who is a refugee to provide breastmilk for an infant – even if doing so leads to malnourishment in the infant from insufficient quantity or quality of breastmilk or malnourishment of older children when their mother can’t collect, scavenge, barter or prepare enough food for them – is a twisted perversion of international aide.

  • Empress of the Iguana People

    What one is educated -in- matters. Like my much loved psychologist uncle who was worrying about the too many, too soon myth of vaccinations. I told him I’m going with boybard’s ped and the CDC recommendation

  • fiftyfifty1

    And also they are weird.